Cesarean Section under General Anesthesia over 10 Years at Tertiary Care Center: A Descriptive Cross-sectional Study.

JNMA; journal of the Nepal Medical Association Pub Date : 2024-09-01 Epub Date: 2024-09-30 DOI:10.31729/jnma.8738
Smriti Basnet, Prabineshwor Prasad Lekhak, Prabin Subedi, Sushila Lama Moktan
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Abstract

Introduction: The global surge in cesarean deliveries necessitates safe anesthetic practices to optimize outcomes. While the neuraxial block is the preferred method, specific conditions warrant general anesthesia. This study is aimed to determine the prevalence of cesarean sections under general anesthesia at a tertiary care center.

Methods: A descriptive cross-sectional study was conducted on cesarean sections performed between April 14, 2013, and April 13, 2023, at a tertiary care center. Ethical approval was obtained from the Institutional Review Committee (Reference number: 20092023/01). Total sampling was done. Data for the past ten years were manually collected from hospital records using a self-structured proforma and analyzed using Microsoft Excel 2018 and IBM SPSS version 26. The point estimate and 95% confidence interval were calculated for the study.

Results: In this study, there were 216 (2.98%) (95% CI: 2.59-3.38%) cesarean sections under general anesthesia in 10 years. Notably, among them, there were 103 (47.69%) primigravida, nullipara 130 (60.19%), 135 (62.50%) with no living children, and 161 (74.54%) without any past abortions. In most cases, 182 (84.26%) were emergency procedures and 34 (15.74%) were elective. Fetal bradycardia with distress was the primary indication observed in 121 (56.02%) cases, followed by 32 (14.81%) maternal requests. Additionally, 21 (2.66%) cases were found initially planned as cesarean sections under subarachnoid block but were converted to general anesthesia. The prevalence in this study was found within the recommended limits.

Conclusions: The findings highlight that the majority of these procedures were emergency cases, predominantly due to fetal distress, with a notable proportion involving primigravida and nulliparous women.

三级医疗中心全麻剖宫产手术10年:一项描述性横断面研究。
导言:全球剖宫产的激增需要安全的麻醉措施来优化结果。虽然神经轴阻滞是首选方法,但特殊情况需要全身麻醉。本研究的目的是确定剖宫产在全身麻醉下的流行率在三级保健中心。方法:对2013年4月14日至2023年4月13日在某三级保健中心进行的剖宫产手术进行描述性横断面研究。获得了机构审查委员会(参考编号:20092023/01)的伦理批准。进行了总采样。使用自结构化格式从医院记录中手动收集过去十年的数据,并使用Microsoft Excel 2018和IBM SPSS version 26进行分析。计算本研究的点估计值和95%置信区间。结果:本研究10年内全麻剖宫产216例(2.98%)(95% CI: 2.59 ~ 3.38%)。其中,初产妇103例(47.69%),无生育130例(60.19%),无子女135例(62.50%),无流产史161例(74.54%)。182例(84.26%)为急诊手术,34例(15.74%)为选择性手术。121例(56.02%)胎儿心动过缓伴窘迫为主要指征,其次为32例(14.81%)产妇要求。此外,21例(2.66%)患者最初计划在蛛网膜下腔阻滞下剖宫产,但后来转为全身麻醉。本研究发现患病率在推荐范围内。结论:研究结果强调,这些手术大多数是急诊病例,主要是由于胎儿窘迫,有显著比例涉及初产妇和未产妇女。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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